Study on the intervention and evaluation for the abnormal results of tacrolimus therapeutic drug monitoring
10.12092/j.issn.1009-2501.2024.12.001
- VernacularTitle:他克莫司治疗药物监测异常结果干预及评价研究
- Author:
Xuebin WANG
1
;
Lihong GAO
;
Lingpeng ZHANG
;
Yunyun YANG
;
Hongxia LIU
;
Zhuo WANG
;
Huajun SUN
Author Information
1. 上海市儿童医院药学部,上海 200062;海军军医大学第一附属医院药剂科,上海 200433;复旦大学药学院生物药物系,上海 201203
- Publication Type:Journal Article
- Keywords:
kidney transplantation;
tacrolimus;
therapeutic drug monitoring;
outcome interven-tion;
Pharmaceutical Care Network Europe
- From:
Chinese Journal of Clinical Pharmacology and Therapeutics
2024;29(12):1322-1328
- CountryChina
- Language:Chinese
-
Abstract:
AIM:To analyze the Pharmaceutical Care Network Europe(PCNE)classification system used for evaluating the drug related problems(DRPs)of tacrolimus concentration fluctuations in kidney transplant recipients.METHODS:Kidney transplant recipients were selected as the study subjects,who experienced fluctuations in tacrolim-us blood concentrations and clinical pharmacist in-tervention during outpatient follow-up.PCNE(9.0)classification system was used to evaluate the DRPs of tacrolimus.And the DRP problems,causes,inter-vention plans,acceptance and status were ana-lyzed.RESULTS:A total of 700 kidney transplant re-cipients were enrolled from July 2019 to December 2021,and 1014 DRPs were found.The problems of DRPs included the occurrence of adverse drug events(P2.1,60.16％)and poor treatment out-comes(P1.2,39.84％);The main reasons included dosage selection(C3,43％),others(C9,38.4％),and drug selection(C1,9.41％);Clinical pharmacists ac-tively intervened at the recipient level(I2,98.92％)and drug level(I3,1.08％);The acceptance rate of the intervention plan(A1.1+A1.3)reached 98.62％,and the complete implementation rate(A1.1)reached 72.09％;79.29％of DPRs were fully or par-tially resolved(O1.1 and O2.1).CONCLUSION:Clini-cal pharmacists can use PCNE to evaluate tacrolim-us therapeutic drug monitoring(TDM)related DRPs,help standardize TDM pharmaceutical ser-vice models,standardize TDM abnormal result in-terpretation and intervention workflows,and pro-mote safe and rational drug utilization.
